Frail Institutionalized Older Persons

Weening-Dijksterhuis, Elizabeth; Greef, M.H.G. de; Scherder, E.J.A.; Slaets, Joris P. J.; Schans, Cees P. van der

doi:10.1097/phm.0b013e3181f703ef

Cited by 141 publications

(56 citation statements)

References 37 publications

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“…Based on a Cochrane review, there is a strong evidence to indicate that exercise targeting endurance, flexibility, balance and strength in community-dwelling frail elders can prevent disability [205]. Similar findings were demonstrated in a systematic review of exercise training programs (n = 27 studies; n = 6459 patients) in frail elders living in LTC facilities [206]. Multiple studies have shown that resistance training in healthy and frail adults can increase physical strength, improve gait speed, reduce the risk of falls or delay the onset and progression of frailty [207][208][209][210].…”

Section: Patient-level Management Identify and Minimize Risk Factors Thsupporting

confidence: 57%

The older patient with heart failure: high risk for frailty and cognitive impairment

Harkness

Heckman

McKelvie

2012

Expert Review of Cardiovascular Therapy

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Managing older heart failure (HF) patients can be complicated by both cardiac and noncardiac conditions. Over the past 20 years, care for HF patients has become more complex, with a rising proportion of older people living with HF. In particular, cognitive impairment (CI) and frailty often coexist with HF in the elderly. With the prevalence of HF, frailty and cognitive impairment rising with age, the simultaneous occurrence of at least two of these conditions in the same individual will become more frequent. The presence of frailty and/or cognitive impairment in older people with HF is independently associated with worse clinical outcomes. The purpose of this review is to provide an overview of frailty and cognitive impairment in older HF patients. Specifically, this article describes the epidemiology of these conditions in HF patients, outlines potential underlying mechanisms, highlights relevant screening tools and reviews relevant clinical implications.

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Section: Patient-level Management Identify and Minimize Risk Factors Thsupporting

confidence: 57%

The older patient with heart failure: high risk for frailty and cognitive impairment

Harkness

Heckman

McKelvie

2012

Expert Review of Cardiovascular Therapy

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“…However, they failed to show any effects on functional performance assessed as grip strength, walking ability, stair climbing and mobility. In contrast, in three systematic reviews [1,11,12] evidence was found showing that physical training had positive effects on mobility, physical functioning and cognition in institutionalized older patients. A Cochrane study [1] concluded that physical rehabilitation in long-term care residents is worthwhile and safe, that it reduces disability and leads to few adverse events such as pain, chest pain or loss of balance.…”

Section: Introductionmentioning

confidence: 96%

Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial

et al. 2012

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Background: Nursing home residents are extremely inactive and deterioration in health and an increasing dependence in activities of daily living (ADL) are common. Physical activity and exercise play a major role in the preservation of physical function and quality of life late in life. However, evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive. Objective: To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength. Methods: In this single-blind randomized clinical trial with parallel groups, nursing home residents >64 years of age from three Nordic countries were included. The intervention group (IG) was assigned to individually tailored physical and daily activities, while the control group (CG) received ordinary care. Primary outcomes were ADL and balance, and secondary outcomes physical activity level, mobility and muscle strength. Results: At baseline, 322 nursing home residents were included, of whom 266 were assessed after 3 months of intervention. Following the intervention, a significant difference was found between participants in the IG and CG on measures of balance, physical activity and transfers. The IG significantly improved walking/wheelchair speed and functional leg muscle strength. The CG had significantly deteriorated in ADL, balance and transfers. Persons who had taken part in the intervention for more than 150 min/week significantly improved their balance and physical activity level. Participation in more than 10 weeks of intervention significantly improved physical activity and walking/wheelchair speed, while a deterioration was seen in those who had participated less. Conclusion: Individually tailored intervention in nursing home residents focusing on physical and daily activities is effective in improving transfers, balance and physical activity level compared to usual care. The effect of the intervention is dependent on the total activity time.

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“…As for institutionalized older persons and frail older persons, there is evidence for training effects on physical fitness, functional performance, and performance of activities of daily living 14,16…”

Section: Introductionmentioning

confidence: 99%

Sustainable effects of a low-threshold physical activity intervention on health-related quality of life in residential aged care

Quehenberger¹,

Cichocki²,

Krajic³

2014

CIA

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BackgroundMobility is a main issue for health-related quality of life in old age. There is evidence for effects of physical activity (PA) interventions on several dimensions of health for the aged and also, some specific evidence for vulnerable populations, like residents of residential aged care. Research on low-threshold PA interventions for users of residential aged care and documentation of their sustainability are scarce. “Low threshold” implies moderate demands on the qualification of trainers and low frequency of conduct, implying low demands on the health status and discipline of users. Yet the investigation of low-threshold interventions in residential aged care seems important as they might foster participation of users and implementation in everyday routines of provider organizations. An initial study (October 2011 to June 2012) had found intervention effects on health-related quality of life. The objective of this study was to examine sustainability of the effects of a low-threshold PA intervention on health-related quality of life in residential aged care.MethodsData collection took place in three residential aged care homes in Vienna, Austria. At 1-year follow-up (June 2013), participants from the intervention group were interviewed using a standardized questionnaire. Using general mixed linear models and Friedman tests followed by paired t- and Wilcoxon signed-rank tests, we compared outcome measures at follow-up with measures obtained at baseline and at the end of the intervention.ResultsAt the 1-year follow-up assessment, participants’ (mean age 84.7 years; 89.7% female) subjective health status was still significantly increased, equaling a small sustainable intervention effect (Cohen’s d=0.38, P=0.02). In comparison with baseline, a significant decline of reported pain/discomfort (P=0.047) was found. Regarding the subdimensions of health-related quality of life, favorable trends could be observed.ConclusionThe study indicates that effects of a low-threshold PA intervention on health-related quality of life in residential aged care can be sustainable. Addressing hindering factors like poor health status and implementing proactive support and individualization of the program to enable PA for residents might foster sustainability of effects.

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Frail Institutionalized Older Persons

Cited by 141 publications

References 37 publications

The older patient with heart failure: high risk for frailty and cognitive impairment

The older patient with heart failure: high risk for frailty and cognitive impairment

Effects of Individually Tailored Physical and Daily Activities in Nursing Home Residents on Activities of Daily Living, Physical Performance and Physical Activity Level: A Randomized Controlled Trial

Sustainable effects of a low-threshold physical activity intervention on health-related quality of life in residential aged care

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